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General NPI Number Information
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NPI Number | 1932996733
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Entity Type | Organization
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Legal Business Name | ROCKHOLD WELLNESS LLC
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 685 CITADEL DR E STE 505
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-5372
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Country | US
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Telephone | 719-318-8662
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Fax |
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Provider Business Mailing Address
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Address Line | 16455 GREAT SMOKEY AVE
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City | ELBERT
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State | CO
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Zip | 80106-9078
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Country | US
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Telephone | 719-318-8662
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RYAN ROCKHOLD
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Credential |
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Telephone | 719-318-8662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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